Safety of Nebulized Ciprodex for Postoperative Management of Tracheal Resection

• Published in: The Laryngoscope Vol. 134; no. 8; pp. 3695 - 3697
• Main Authors: Chwa, Jason S., Shuman, Elizabeth A., O'Dell, Karla
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-08-2024; Wiley Subscription Services, Inc
• Subjects: airway stenosis/reconstruction; outcomes; trachea; trachea; outcomes; airway stenosis/reconstruction
• ISSN: 0023-852X; 1531-4995; 1531-4995
• DOI: 10.1002/lary.31428

Objective
Anastomotic complications after tracheal resection/cricotracheal resection (TR/CTR), such as granulation tissue formation, can lead to severe morbidity. The off‐label use of nebulized ciprofloxacin‐dexamethasone (Ciprodex) for granulation tissue prophylaxis has anecdotally been used after TR/CTR, especially in pediatric patients. However, its use in the adult population, and its safety and side effect profile post‐TR/CTR has not been reported. This study aims to characterize the incidence of adverse side effects associated with nebulized Ciprodex in post‐TR/CTR patients.
Methods
A retrospective review of all patients who underwent TR/CTR from June 2015 to July 2023 was performed. The use of nebulized Ciprodex (1 mL ciprofloxacin‐dexamethasone 0.3%–0.1% otic suspension in 4 mL normal saline) while inpatient was evaluated. Potential side effects were defined as oral thrush, ageusia, arthralgia, and allergic reaction, and were recorded for all patients.
Results
Seventy‐three patients underwent TR/CTR from June 2015 to July 2023. Of these, 53 (72.6%) had documented Ciprodex administration during their postoperative course. One (1.9%) patient reported at least one side effect, including one instance of skin rash (1.9%) and one instance of allergic reaction (1.9%). There were no other side effects attributed to Ciprodex use.
Conclusions
The incidence of side effects related to the use of nebulized Ciprodex is felt to be minimal in post‐TR/CTR. Although Ciprodex may have the potential to treat granulation tissue in the airway, further studies are needed to verify its efficacy and safety.
Level of Evidence
4 Laryngoscope, 134:3695–3697, 2024